Journal
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
Volume 108, Issue -, Pages 129-136Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ijid.2021.05.028
Keywords
Next-generation sequencing; Tuberculosis; Sarcoidosis; Diagnosis; Clinical biopsy specimens
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Funding
- Shanghai Science and Technology SMEsTechnology Innovation Fund [1702H117500]
- Jiaxing Leading Talent Entrepreneurship Project, and Technology Innovation Projects of Jiaxing [2021BZ10004]
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This study established an improved NGS strategy for rapidly distinguishing patients with TB from those with SA, with high sensitivity, specificity, and concordance. The NGS method shows potential clinical benefits in the accurate diagnosis of TB and SA.
Objectives: Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (MTB), has similar clinical, radiological, and histopathological characteristics to sarcoidosis (SA). Accurately distinguishing SA from TB remains a clinical challenge. Methods: A total of 44 TB patients and 47 SA patients who were clinically diagnosed using chest radiography, pathological examination, routine smear microscopy, and microbial culture were enrolled in this study. The MTB genome was captured and sequenced directly from tissue specimens obtained upon operation or biopsy, and the feasibility of next-generation sequencing (NGS) for the MTB genome in the differential diagnosis of TB from SA was evaluated. Results: Using a depth >10x and coverage >15% of the sequencing data, TB patients were identified via the NGS approach directly using operation or biopsy specimens without clinical pretreatment. The sensitivity, specificity, and concordance of the NGS method were 81.8% (36/44), 95.7% (45/47), and 89.0% (81/91), respectively (kappa = 0.78, 95% confidence interval 0.65-0.91; P < 0.001). Conclusions: This study established an improved NGS strategy for rapidly distinguishing patients with TB from those with SA and has potential clinical benefits. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
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